title: Airway inflammation and bronchial hyperreactivity in steroid naive children with intermittent and mild persistent asthma.
abstract: BACKGROUND
  Intermittent and mild persistent asthma are defined according to symptom frequency and spirometry and treated differently. To our knowledge, there is no study comparing airway inflammation between intermittent and mild persistent asthmatic children.
  
  
  METHODS
  Children aged 7-16 years, referred to our pediatric allergy clinic for recurrent respiratory complaints underwent a detailed clinical history and spirometry with reversibility. None of the subjects had been using regular anti-inflammatory treatment. After a 2-week run-in period during which asthma symptoms were recorded, exhaled NO measurement, bronchial provocation test with adenosine monophosphate and methacholine and sputum induction were performed. Data of patients with intermittent and mild persistent asthma and a control group were compared.
  
  
  RESULTS
  Thirty intermittent, 26 mild persistent asthmatic children, and 21 control subjects were studied. Sputum was obtained from 19 of intermittent asthmatics (63.3%), 18 of mild persistent asthmatics (69.2%), and 13 of control subjects (61.9%). Eosinophil count and exhaled nitric oxide were not different between asthmatic groups. Neutrophil count of children with mild persistent asthma was higher than the intermittent asthmatic group (P = 0.003). Geometric mean of PC20 methacoline values were not different between groups (P = 0.058). Geometric mean of PC20 AMP was lower among patients with mild persistent asthma (P = 0.102).
  
  
  CONCLUSIONS
  Eosinophilic airway inflammation and direct BHR may not be significantly different in intermittent asthmatic children from their peers with mild persistent disease. Neutrophilic airway inflammation and BHR to an indirect stimuli are more pronounced in the mild persistent group.
authors.affiliation: Department of Pediatric Allergy and Immunology, Ankara Pediatric Health and Disease Hematology Oncology Research and Education Hospital, Ankara, Turkey.
authors.forename: Muge
authors.initials: M
authors.lastname: Toyran
authors.forename: Arzu
authors.initials: A
authors.lastname: Bakirtas
authors.forename: Funda
authors.initials: F
authors.lastname: Dogruman-Al
authors.forename: Ipek
authors.initials: I
authors.lastname: Turktas
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D015415:Biomarkers / Q000378:metabolism; D001944:Breath Tests; D016535:Bronchial Hyperreactivity / Q000175:diagnosis*; D001985:Bronchial Provocation Tests; D016022:Case-Control Studies; D002648:Child; D004804:Eosinophils / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D008297:Male; D009504:Neutrophils / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism; D012720:Severity of Illness Index; D013147:Spirometry; D013183:Sputum / Q000378:metabolism
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide
keywords: AMP; induced sputum; methacholine; mild asthma; nitric oxide